Renal failure, also known as kidney failure, is the major reason for electrolyte imbalance. Sodium, the most abundant electrolyte in the body, affects how much urine the kidneys produce and plays a role in the transmission of nerve impulses. Too much or too little sodium can quickly become a major problem and cause life-threatening conditions.
Renal Failure
Renal failure can be acute, meaning a sudden onset, or chronic, or occurring over a period of months to years. With acute renal failure, if the underlying cause can be resolved, kidney function can be regained. Chronic renal failure is a progressive, irreversible loss of renal function. The primary function of the kidneys is to rid waste products from the body through urine.
Sodium
Sodium is the most abundant electrolyte found in the fluid outside the cells and is responsible for transmitting nerve impulses and muscle contractions and regulating blood pressure. According to the book "RN," water follows salt in the body, so a gain or loss in sodium results in a gain or loss in water. When the body has too much salt, it will trigger the release of a hormone called antidiuretic hormone, or ADH. ADH lets the body know it should hold onto water to help balance the excess amount of salt. If there is not enough salt, the body inhibits the release of ADH and allows more water to be excreted by the kidneys.
Complications
When kidney function is impaired and excess sodium is not excreted, it will build up in the bloodstream and tissues. When this occurs, there is an impact on other major systems that will lead to complications. The accumulation of sodium causes a buildup of fluid in the bloodstream that puts additional workload on the heart, weakening it and leading to heart failure. Blood pressure increases, which causes more damage to the already unhealthy kidneys.
Symptoms
Patients who have a build up of sodium, called hypernatremia, appear thirsty, have an increased heart rate and are sleepier than usual. As the levels of sodium continue to increase, cells become dehydrated, and the patient becomes disoriented, weak and irritable with muscle twitching. Urine output is low because the body is attempting to hold onto water.
Treatment
The goal of treatment is to regain function of the kidneys and excrete excess sodium to maintain a balance for normal functioning of the cells. Treatment may include diet modifications to decrease the intake of sodium and fluids. Medications may be prescribed to control high blood pressure. Patients with kidney failure require close monitoring of their fluid intake and output. In cases of irreversible kidney damage, the patient may require dialysis.
References
- "RN"; Restoring Electrolytes; Astle; May 2005
- "Fluids and Electrolytes DeMystified"; McGraw Hill; 2008
